Endometriosis affects women in their reproductive life and is a chronic disease. It is an important cause of dysmenorrhea, chronic pelvic pain and infertility. Diagnostic and therapeutic challenge is faced by clinicians as the disease tends to come back. Management is usually directed at relieving the symptoms and improving the chances of fertility which is either medical or surgical or a combination of the two. Some women with endometriosis might be asymptomatic, most have chronic abdominal &/or pelvic pain. Research is directed to find out ideal medication for endometriosis, with good efficacy, minimal or least side effects, cost- effective, and cantargets the basic pathology of disease to cures it. However, such cure is yet to be found. Many drugs are used to treat endometriosis- NSAIDs, combined oral contraceptive agents, Progesterones (oral, injections and local as intra uterine device. Every drug has its side effects and safety profile. Progesterones are generally preferred in very young as well as older women who cannot take long term OCP due to estrogenic side effects or contraindication Dienogest, a newer progestogen is closer to the ideal agent. Its profile is discussed below along with comparison with other progestins which are already being used. Other potential progestins are also discussed providing a whole spectrum of drugs with different efficacy and profiles.

Keywords: Endometriosis; Progesterones; DMPA; Dienogest; Levonorgestral Intrauterine System.